怎样治疗白斑

如何治疗白斑配图，仅供参考

Vitiligo
Vitiligo is an autoimmune depigmenting disorder of the skin. The depigmentation results from the loss of epidermal melanocytes. Clinically presenting with well-demarcated white patches on the body,vitiligo can be cosmetically very disabling and create a psychological burden ). There has been a great advance in understanding the pathological basis due to current research. JAK kinase signaling pathways and the cytokines involved in the Th1 pathway are the focus of the upcoming vitiligo treatments,followed by antioxidant and repigmenting agents ).
Diagnosis
Vitiligo is usually diagnosed clinically ). Occasionally skin biopsy may be recommended ). A characteristic histological hallmark is the absence of melanocytes and epidermal pigment ). Screening to assess potential autoimmune diseases is recommended.
Treatment
Therapy of vitiligo is currently unsatisfactory. Topical treatments include corticosteroid and calcineurin inhibitors ). Phototherapy,ranging from broadband,or narrowband UVB to psoralen plus UVA,may be another option ). In severe or treatment-refractory cases systemic treatments include mini-pulses of oral steroids,methotrexate,cyclosporin or mycophenolate mofetil. Currently,there are several drugs available,alone or combination,aiming to arrest progression and induce repigmentation of the skin. The degrees of repigmentation vary ). Of note,there is no approved treatment for vitiligo repigmentation and current off-label therapies have limited efficacy. This emphasizes the need for better treatment options.
Perspectives
It is essential to increase awareness of the comorbidities associated with the disorder. The most common comorbid conditions of vitiligo are thyroid disease,diabetes mellitus,Addisons disease,pernicious anemia,rheumatoid arthritis,inflammatory bowel disease,ocular and audiological abnormalities,alopecia areata,systemic lupus erythematosus,Sj?grens syndrome,dermatomyositis,scleroderma,psoriasis,and atopic dermatitis ). Among emerging treatments that may meet the need for safe and effective vitiligo treatments,JAK inhibitors (topical and oral) are the most promising new class of drugs currently available and act best in conjunction with phototherapy ). The result from the phase III TRuE-V clinical trial program ),evaluating the topical JAKi ruxolitinib (Opzelura™ cream) showed a substantial repigmentation of vitiligo lesions. Hence,approval in the U.S. and Europe is expected in the upcoming months. Further treatment potential options like phosphodiesterase inhibitors (PDE4) or abatacept,a fully human fusion protein of CTLA-4 and the Fc portion of human IgG1 are sometimes used off-label. Considering the role of PD-1 ligand (PD-L1,a PD-1 agonist) and CTLA-4 in maintaining immune balance,targeting this pathway could be a therapeutic option. Furthermore,it was shown,that IL-15 acts via JAK STAT signaling pathways and has been recently implicated in oxidative stress mediated destruction of melanocyte. Thus,the future of vitiligo treatment may rely on the development of more specific drugs ).","department":"